PBS reports that most nursing homes are understaffed. A nursing home’s failure to hire enough qualified staff members, like registered nurses, causes harm to residents. If your loved one sustained harm or neglect while at a nursing home, understaffing might be partly to blame. The nursing home can be liable for harm that results from neglecting to hire enough personnel to care for the residents.
A lawyer who handles nursing home cases can help. Call Pintas & Mullins Law Firm today at (800) 842-6336 to learn more about your legal options. The initial consultation is free, and there is no obligation.
How Understaffing in Nursing Homes Can Hurt Residents
People move into nursing homes because they need daily assistance with medical treatments and personal care, like eating, bathing, and dressing. If a facility fails to hire enough personnel to meet those needs, the residents can suffer from neglect.
Here are some examples of gaps in care that nursing home residents can experience because of inadequate staffing:
- Untreated wounds: Without treatment, wounds may become unclean, leading to infection, sepsis, and amputations.
- Irregular baths or showers: Staff members who do not bathe the individual daily can contribute to infections and other medical issues.
- Lack of movement: Some nursing home residents are bedridden, which means staff must move them periodically to prevent the development of bedsores.
- Lack of social activities: When staff members do not schedule social activities (or help residents get to those activities), residents may experience isolation, loneliness, depression, cognitive decline, and dementia.
- Failing to change residents’ clothing: Residents might wear the same unsanitary clothes day after day.
- Poor nutrition and dehydration: There might not be enough employees to help everyone who needs assistance at mealtimes. This can lead some residents to be malnourished or dehydrated.
- Chemical restraints: Burnt-out workers might resort to the improper use of medication to make residents docile. This is referred to as chemical restraint. Chemical restraints are illegal and dangerous.
- Resident-on-resident abuse:With a lack of supervision, abuse amongst residents can increase and escalate.
- Medication errors: Medication errors can increase if workers must rush through medication rounds. Employees without sufficient training to dispense drugs can also cause medication errors.
- Self-help: Residents may attempt to do things for themselves, such as walking to the bathroom alone, which can result in falls and other accidents.
- Abuse: Stressed and overworked medical staff may also abuse residents.
If your loved one experienced one of these situations or sustained a different type of harm, understaffing could be at the heart of the problem. When understaffing hurts residents, you can – and should – hold the facility liable for any losses you or your loved one incurred.
Call Pintas & Mullins Law Firm today if your loved one suffered neglect or abuse due to understaffing in a nursing home.
The Scope of the Problem
You cannot rely on the staffing report that a facility provides to you. A nursing home may claim to employ more employees like registered nurses than they actually do.
According to the PBS report, Kaiser Health News compared payroll records of over 14,000 nursing homes to staffing reports submitted by facilities to Medicare.
The report shows a discrepancy between the number of employees nursing homes claimed were on staff, and the number of people they actually hire.
For example, when a facility says it has 40 workers, that number is reflective of the day that has the highest number of employees working. The Kaiser News Report stated that on the day with the lowest staffing, there maybe half as many employees present. One nursing home mentioned had a resident-to-staff ratio of 18-1 on its lowest-staffed days. On its best-staffed days, there was one aide for every eight residents. The danger of inadequate or inconsistent staffing that could affect the residents’ needs remains the same every day.
Medicare does not require a certain number of staff members as it relates to residents. Medicare’s minimum standards do require at least one licensed nurse at a nursing home at all times – 24 hours a day, seven days a week. Nursing homes must hire a registered nurse on-site for eight hours a day.
Many facilities do not meet these minimum standards. If a failure to meet any standards related to staffing caused your loved one to suffer harm, we can help you hold the facility liable.
For a free legal consultation, call 800-934-6555
To ensure optimal care, the ratio of staff to patients in nursing homes proves paramount. Unfortunately, many nursing homes do not meet their staffing benchmark for different reasons. When this happens, the residents suffer since they may receive treatments that fall below the standard of care. Some causes of understaffing in nursing homes include:
- Financial gain: Some nursing home facilities focus more on maintaining or increasing their profit margins and generating a return for the owners and investors. They may take actions that include admitting more patients during periods when they do not have an adequate number of certified nursing assistants and other caregivers.
- Insufficient funding: Sometimes, the cost of medical equipment and hiring medical professionals lead some nursing home facilities to hire few people. They may attempt to curb staff due to management’s inability to employ fully trained nurses and other staff while simultaneously investing in the facilities that keep daily operations running smoothly.
- Absence of properly trained professionals: Due to the medical community’s standard of care, nursing homes can employ only trained and licensed medical staff. At times, they may have a hard time finding the right people to provide adequate care for residents. When this happens, the existing staff have no choice but to work overtime to meet the needs of residents.
- Inadequate management: When those in charge of running the facility underestimate their responsibilities or fail to grasp the importance of staff to patient ratio, understaffing may occur. Qualified people need to run a nursing home facility since they may take actionable steps to ensure that every aspect of the residents’ care balances out.
Effects of Understaffing in Nursing Homes
According to studies from the Journal of the National Medical Association, understaffing in nursing homes can lead to:
- Neglect of residents’ needs: Most elderly adults in nursing homes remain extremely dependent on caregivers for their basic needs, including eating, bathing, moving, eating, and taking medications. An imbalance in the ratio of nurses to patients can lead to residents developing sores, infections, and even malnutrition.
- Abuse of residents: Nurses employed in a high-stress environment with limited staff are likely to be abusive to their patients. Their actions, completely unacceptable in every instance, may include increased control, isolation of patients, being verbally abusive to patients, gaslighting, hitting or kicking patients, and intentionally breaching their duty of care.
- Absence of individualized care: Understaffing makes it difficult and sometimes nearly impossible for nurses to care for their patients. With a limited staff, patients may suffer injuries in a slip and fall accident due to a lack of supervision. They may also feel depressed or have severe anxiety in the absence of attentive caregivers.
- Stress and frustration: Most nurses source motivation from their natural desire to help others. When placed in an understaffed environment, they may lack the ability to provide optimal care due to exhaustion and burnout. This can impact their health, as well as lead to frustration and cause them to act in a way that falls below their communities’ standard of care.
To ensure continuous optimal care and prevent nursing home staff from feeling frustrated and overworked, nursing home administrators must tackle the issue of and causes of understaffing. To do so, management must:
- Create space for open communication: By allowing the staff to voice out their frustrations easily, management may know how to take the right steps to ease their burdens.
- Hire the right number of professionals: Nursing home facilities must not compromise when employing people. Taking this step helps ensure that the residents receive the care they deserve.
- Invest in the right medical equipment: Where it applies, the right medical equipment can make a caregiver’s job easier and result in increased productivity and high-profit margins for the nursing home.
The staff of a nursing home provides an integral role in the facility. Unfortunately, when nursing homes operate understaffed, the residents may suffer from their negligence, according to the National Institutes of Health (NIH). Understaffing routinely occurs due to an annual turnover rate of approximately 85% in nursing homes annually throughout the country.
Between regulating patient medications, helping with important social interactions, and otherwise keeping up with a patient’s ongoing care, caregivers can experience burnout and decide to leave suddenly. When caregivers and certified nursing assistants (CNA) leave gaps in the staff, the residents can suffer greatly. Several reasons may contribute to an understaffed nursing home, including monetary issues, a high turnover rate, and a lack of qualified candidates. There is no excuse for these types of indiscretions.
Regardless of these issues, the U.S. Department of Justice mandates nursing homes to provide a certain level of quality care according to nursing home staffing standards. When a nursing home employs proper practices to ensure a certain quality of care and staffing, the same issues and accidents prove avoidable.
Expenses Increase as Quality of Care Decreases Due to Understaffing
Understaffing does not only affect the resident of the nursing home but the nursing home itself as well. NIH studies showed that the average costs of turnover in nursing homes to be $167,063 for locations that experienced high turnover rates of their staff. When understaffing results in improper care, the consequences can prove deadly for nursing home residents. Further, the effects of understaffing can include, but are not limited to:
- A lack of worker-resident relationships that can have a negative mental effect on patients.
- Inadequate staff to deliver medications to patients exactly as they need them, which can include specific dosages, brands, and ingestion methods (for example, whether or not the medication needs to be ground up, injected, placed under the tongue, etc.).
- Staff may have to care for too many residents at once, resulting in a costly inattention to detail that can affect the safety of the patients.
- Residents may not receive proper medical care until it is too late, causing issues such as injuries, mental illness episodes, overall health issues, lack of personal needs, and more.
- Inexperienced staff members may have too much responsibility for their skillset.
- Staff members may have so many tasks that they forget to properly clean the facilities, which can facilitate the spread of dangerous diseases, viruses, and invasive species (such as mites and bed bugs).
- Ongoing stress of staff’s multi-faceted positions may lead to burnout, which subsequently affects their ability to properly perform their job duties.
- Workers may have to work long hours to make up for the lack of employees, which can lead to a higher likelihood of mistakes.
- An increased risk of workplace accidents, such as wet floors, improperly secured items, and other forms of negligence by staff may occur.
Sometimes the effects of understaffing may appear visibly, while other factors may have a more gradual decline. These issues prove especially hard to define if you have a loved one in a nursing home facility that has trouble communicating. By always looking out for tell-tale signs like unexplained bruises, malnutrition, deliriousness, changes in demeanor, and a lack of cleanliness, you can help prevent these issues from spreading any further. Nursing home abuse takes many forms, and understaffing classifies as a frequent contributor.
Understaffing High Turnover
High turnover rates in nursing homes represent a significant factor in cases of elder abuse, and currently85.8 percent of nursing homes suffer from high certified nursing assistant (CNA) turnover, according to the National Institutes of Health (NIH). In 2010, the NIH estimated that high turnover rates cost nursing homes about $167,063 a year.
The best nursing homes employ caregivers who can build long-lasting relationships with their patients. Without that connection, caregivers and CNAs can burn out and quit, leaving residents without the comfort they deserve at this stage in their life. After all, long-term exposure to the people you work with, in any capacity, helps you deliver the best results on a consistent basis. Unfortunately, high turnover rates at nursing homes mean their staff creates a revolving door of new faces who never quite settle into their profession.
Relationships aside, high turnover rates can result in inexperienced or downright negligent staff being assigned to care for the home’s residents. The less time the employee spends at the nursing home, they lose the capability to handle the day-to-day necessities that the residents need. Further, rushing through the hiring process to replace staff members can result in the unqualified employees hired, thus continuing the cycle of negligence. The reason for the high turnover rate can vary and usually signal inadequacies at all levels of the care facility.
Potential Reasons for a High Turnover Rate
The reasons for a high turnover rate in a nursing home can depend on underlying issues with the structure of the business. If the company does it’s part to properly investigate its employees before hiring, the nursing home can avoid these issues. Some factors that may further contribute to the high turnover situation include:
- Poor background checks for job candidates.
- Issues with the management or the way the company runs.
- Insufficient salaries.
- The nature of the work and the emotional toll it can take.
- Poor communication among the staff.
- Inexperienced staff members.
- Criminal charges against staff members.
Other reasons for understaffing and high turnover may play a role as well.
Effects of High Turnover of Nursing Home Staff
In a line of work as sensitive as nursing home care, the staff not only needs experience with the basic tenets of medicine but also the ability to give emotional support to their residents. Nursing homes should provide a place where residents can live out what should classify as a peaceful period in their lives. As they reach an age when they cannot properly care for themselves anymore, the staff needs to include individuals equipped to excel in their delicate position.
When nursing homes fail to meet these requirements, the nursing home can quickly run through a wide array of employees. This creates an atmosphere of instability, which may then spread throughout the care facility at every level. The effects of high turnover rates can include, but are not limited to:
- A failure to maintain important worker-resident relationships to keep residents in good spirits.
- Staff’s inability to properly understand the intricate needs of individual residents.
- Residents not receiving proper medical care.
- Inexperienced staff.
- Improper cleaning techniques, which may result in the spread of viruses or diseases.
- Residents who suffer from dementia or other memory-loss conditions remaining confused by the constant revolving door of staffers.
- Residents feeling emotionally mistreated by staffers who do not know their unique personalities.
- Staff’s inability to properly learn the systems needed for care.
Without dedicated staff members, the quality of care in nursing homes decreases.
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Understaffing Lack of Properly Trained Staff
Inadequately trained staff contributes to cases of nursing home abuse and neglect, according to the National Institutes of Health (NIH). As opposed to malicious intent, many of these circumstances simply occur because the staff did not quite know what they were doing. These cases place blame on the nursing home itself, as nursing homes have a legal requirement to uphold nursing home staffing standards and make sure their staff receive adequate training to provide the care nursing home residents need.
As many residents of nursing homes cannot properly care for themselves, this makes it even more important that staffing and quality of care in nursing homes be held to a high standard. Whether they need a strict medicinal regiment to keep them in proper health, proper psychological care, or even something as simple as making sure they eat regularly, discrepancies in care can cause serious ill-effects to the residents when there is a lack of properly trained staff.
When a nursing home fails to properly train its staff, it robs these citizens of their basic rights. They deserve better. Unfortunately, improperly trained staff represents an issue that comes up frequently in legal cases brought against nursing homes, playing a major role in instances of negligence and abuse.
Improperly Trained Staff in Nursing Homes Create Room for Errors
Care facilities can avoid issues if they do their due diligence by exercising background checks and implementing proper training programs. With better guidance and industry knowledge, the residents may enjoy safety and comfort in a nursing home. Instead, negligence from inexperienced staff can bring residents physical and mental anguish.
improperly trained employees can create the possibility for plenty of accidents and issues to residents who are already vulnerable to a multitude of injuries. Generally, these types of negligent acts may include:
- Improperly delivered medications, including brands, dosages, and ingestion methods, which the resident may depend on to continue their way of life.
- Improper feeding, such as when caregivers fail to provide residents food or liquid at the proper time to match their unique medicinal needs.
- Malnutrition from neglectful employees.
- Injuries sustained by residents without proper supervision.
- The spread of diseases, invasive species (such as mites), and bacteria due to improper sanitation and cleanliness.
- Emotional disturbances.
- Issues involving mental illnesses or disorders of the brain, such as dementia, which can result in injury, loss of passions, and death in some cases.
- Severe injury resulting from falls.
The sole responsibility of the staff revolves around providing a quality of care that allows for the safety and comfort of the patient. Yet, with ongoing issues that plague nursing homes like the need for higher minimum staffing standards, a lack of proper training programs, insufficient background checks, and overall negligence from the staff, patients remain susceptible to harm. When this happens, family members may hold the nursing facilities accountable for the lack of properly trained staff.
Getting Legal Help for a Claim Against a Nursing Home
If your loved one sustained harm while a resident at a nursing home, you may want to talk with a lawyer about whether understaffing was a cause or a contributing factor. The nursing home will likely have insurers and a defense team on its side. You do not want to handle this alone. A nursing home lawyer can fight on your behalf. We handle cases across the United States.
You will not need to pay upfront legal fees. We handle these cases on a contingent-fee basis. This means you pay us nothing unless and until we win your case.
Do not let the nursing home that abused your loved one go unpunished. Call Pintas & Mullins Law Firm today at (800) 842-6336 for a free case evaluation. You should not have to pay medical bills and handle other losses due to preventable harm caused by understaffing at a nursing home.